GAD, C Peptide, Islet - what?

[LunaCrystal]

Welcome to the LADA community! A few questions:

1. Would you know what's the normal range for your C-peptide test? My last C-peptide result was 0.31 nmol/l and that's below the normal range (0.37) but still quite good for a Type 1/LADA diabetic.
2. What are your fasting and post-prandial (2 hours after eating?) levels? Waiting until August seems a bit long. If I was you I would get a blood glucose meter and try to find out.
3. In the meantime, you can try follow a low-carb diet.

Don't be afraid of being put on insulin. Taking insulin can help you retain whatever the remaining capacity you have for your body's insulin production.

I'm not sure what my normal is, the number on the letter was 1.08? Yes I think a glucose meter would be a good step to understanding more.

I wrote on this forum because my letter said LADA on it, and that was from the NHS. No idea what is officially recognised by them just what was written.

 

[Ian DP]

I would not worry too much about the official line, LADA or T1 in honeymoon period, seems like even in the NHS they refer differently to it. What it almost undoubtably means is that most of your insulin making beta cells are dead, but that you still have some remaining (Dr says I have around 10% of my beta cells remaining), you may well be similar. Thus you are definitely still producing some of your own insulin.
In my opinion, you must get yourself a BG meter and start testing very quickly, before and after meals. This will quickly (over about a month) tell you what foods elevates your BG levels. I tested about 10 times per day initially, but now only once or twice (because I am not on insulin). If you can keep your BG levels down to around 5 fasting and 6 two hours after eating, you will retain what beta cells you have remaining for a much longer period. If you let your BG levels get high your few remaking beta cells will quickly die off.

 

[Daibell]

That's true the nhs does not recognise lada just type 1 and 2 which I don't understand why that's the case

'cos the NHS is out of date with regard to diabetes types and so is Diabetes UK. We are on our own folks together with this great site. A C-peptide of 1.08 is quite low and similar to mine and indicates insulin production is quite low. The GAD >200 is positive and indicates LADA.

 

[TorqPenderloin]

1.08 would be considered on the lower side of "normal" at least by the standards I've seen. You probably couldn't maintain normal blood levels on a standard diet at without insulin

5 months ago, my c-peptide was .7 at diagnosis. At that level, I was able to keep my blood sugar regulated without insulin through an ultra low carb diet and heavy exercise levels. I have no idea what it is now, but it's definitely lower than .7

 

[Lesleywo]

1.08 would be considered on the lower side of "normal" at least by the standards I've seen. You probably couldn't maintain normal blood levels on a standard diet at without insulin

5 months ago, my c-peptide was .7 at diagnosis. At that level, I was able to keep my blood sugar regulated without insulin through an ultra low carb diet and heavy exercise levels. I have no idea what it is now, but it's definitely lower than .7

Can I please ask what the range is for C-peptide? Thanks

 

[TorqPenderloin]

.8-3.1 ng/ml is the range I found on Google. Or .26-1.03 nmol/l depending which unit of measurement is used.

Edit- I'm in the US and my .7 reading was ng/ml

 

[LucySW]

I would not worry too much about the official line, LADA or T1 in honeymoon period, seems like even in the NHS they refer differently to it. What it almost undoubtably means is that most of your insulin making beta cells are dead, but that you still have some remaining (Dr says I have around 10% of my beta cells remaining), you may well be similar. Thus you are definitely still producing some of your own insulin.
In my opinion, you must get yourself a BG meter and start testing very quickly, before and after meals. This will quickly (over about a month) tell you what foods elevates your BG levels. I tested about 10 times per day initially, but now only once or twice (because I am not on insulin). If you can keep your BG levels down to around 5 fasting and 6 two hours after eating, you will retain what beta cells you have remaining for a much longer period. If you let your BG levels get high your few remaking beta cells will quickly die off.

Just to agree, completely, with Ian's post. That's what you need to do.

 

[Kristin251]

I jus had mine and it was .6 with a GAD over 250. The range I was given was 1.1 - 4.4. Even VLC I need insulin. Am I still in thee Honey moon? Does it need to be zero to be out? Good to know staying between 5 and 6 preserves Beta cells. My A1C was 5.1 so I guess I am there most of the time. Doc also said it was good to still produce some insulin for protection

 

[LucySW]

Yes, it is - it insulates you from up/down swings and hypos. With v low carb, you can prolong it - who knows how long? I'm still honeymooning.

 

[Ian DP]

I have very little knowledge on the c-peptide, I have never had it done, but have asked my consultant for it. He said..... A c-peptide test is an indication of the amount on insulin your body is making at a particular instant in time. If the test was done 3 times during one day a few hours apart you would get different readings. If you had one test every day over a week you would get different readings. When the body needs insulin it produces more, when it doesn't it produced less..... Hence why he won't do a c-peptide test on me, because we know my insulin making ability is small, but that it does still make some (I am not on insulin yet)..... So I would not worry too much about the reading number.... It's small and thus your bodies ability to produce insulin is minimal.

 

[Ian DP]

An A1c of 5.1 is very good. Keep your A1c to around 5.1 and your chances of keeping in the honeymoon period for years to come is very good.

 

[cz_dave]

I have very little knowledge on the c-peptide, I have never had it done, but have asked my consultant for it. He said..... A c-peptide test is an indication of the amount on insulin your body is making at a particular instant in time. If the test was done 3 times during one day a few hours apart you would get different readings. If you had one test every day over a week you would get different readings.

Just an excuse for not doing the test. If you have it done in the morning, fasting and then redo it again under the same circumstances, the results would be comparable.

 

[Daibell]

Just an excuse for not doing the test. If you have it done in the morning, fasting and then redo it again under the same circumstances, the results would be comparable.

I agree. Whilst there are some arguments about when the c-peptide should be done, having it done as a fasting test will give some consistency. It's not a perfect test but better than nothing and guessing the state of your pancreas.

 

[Daibell]

Also probably worth saying that taking Gliclazide is one measure of the state of your pancreas as it stimulates the islet cells. In my case taking max dose of 320 mg/day eventually had no effect meaning there were too few islet cells left to stimulate. So when Gliclazide has no effect then it's time for insulin?

 

[cz_dave]

By the way I see some people have the LADA tag here while others have 1.5. Is there any difference?

 

[Kristin251]

From the best of my knowledge LADA and 1.5 are the same. It is somewhere between T2 and T1 having characteristics of both.

With my GAD being as high as it was I was told I had no choice to be on insulin. I have been VLC for many many years and BS was still quite high hence the insulin. I am on very small doses but I eat small meals as well.

Lucy
Good to know there is some protection left too. How long have you been honey mooning and on insulin if you don't mind my asking?

 

[Lesleywo]

I've had 2 c-peptide tests (different labs):

Jan 2015 - 589 (Range: 280-1250)
May 2015 - 0.75 (Range: 0.4-1.5)

GAD positive, have been for some years. Obviously I am producing insulin .. just wondered what anyone would think about where I sit in the range?

 

[LucySW]

I have been VLC for many many years and BS was still quite high hence the insulin. I am on very small doses but I eat small meals as well.

Lucy
Good to know there is some protection left too. How long have you been honey mooning and on insulin if you don't mind my asking?

Hey

Dx June 2014, on basal Sept to December (it made no difference really, I needed bolus), then bolus + basal MDI Jan 2015 to present (which made a huge difference).

While on MDI, daily insulin has sometimes climbed from 12 u (2 + 2 + 2 bolus, 3 + 3 basal) in total to 13, but then sometimes drops to 11, as at the moment. My mean BG has varied betw 5.8 and 5.2, and is very affected by what I do, i.e. if I do anything stupid. But it still always improves, if I exercise/don't eat late/don't snack.

My impression is I still have quite a lot of insulin going. I want to keep it!!

Edit: I forgot to say, all this time I was following a Dr Bernstein-ish 30 grams carb per day diet. Eggs, reasonable not huge amounts of meat, chicken, fish, and quite a lot of butter and cream, but masses and masses of green veg, which I like anyway.

LSW

 

[cz_dave]

I've had 2 c-peptide tests (different labs):

Jan 2015 - 589 (Range: 280-1250)
May 2015 - 0.75 (Range: 0.4-1.5)

GAD positive, have been for some years. Obviously I am producing insulin .. just wondered what anyone would think about where I sit in the range?

I think these are fasting ranges. And if you were fasting when doing the test, then your insulin production is normal.

 

[LunaCrystal]

If my blood sugar is going between 8 and 11, am I damaging my remaining islet cells and should I be on insulin? They don't seem that high?